Amy M Breisch, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22004430A Issued in IN

Practice address

4646 N 800 E
Kokomo, IN 46901-8440

Phone

(765) 860-1684

NPI assigned

Apr 19, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Amy M Lee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1023282175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 N 800 E",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469018440",
            "telephone_number": "765-860-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N 800 E",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469018440",
            "telephone_number": "765-860-1684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W Stafford Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474033853",
            "country_code": "US",
            "telephone_number": "812-606-5636",
            "fax_number": "812-339-8232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREISCH",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-19",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004430A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "LEE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chad Alyn Bradley, PTA
• Denise Bradley
• Gwendolyn McClelland Bragg
• Anisa Braja, PHARMD
• Kimberly Jo Branyan, MA, BCBA
• Eric Daniel Breisch
• Jeffrey Nicholas Brentin, DO
• Rachel Bridges, FNP
• Emma Briggs
• Mackenzie Katherine Bristol

• Speech-Language Pathologist in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.